患者认为等待是值得的吗? 来自一个分辨选择实验的证据
Ching-Heng Wu1, Shelby D Reed2,3, Jui-Chen Yang3
1RTI-Health Solutions, Durham, NC, USA. chinghengwu@rti.org.
The patient
|September 4, 2025
概括
随着移植等待时间的增加, 越来越多的患者愿意接受低质量的器官. 健康状况和收入等因素影响患者对已故捐赠的偏好.
科学领域:
- 肝脏病学
- 移植手术
- 健康经济学
背景情况:
- 在美国,每年大约有30%的已故捐赠脏被丢弃.
- 许多等待移植的患者表示愿意接受低质量的器官以缩短等待时间.
研究的目的:
- 评估患者对较低质量的脏的偏好如何随着脏移植等待名单上的时间的增加而变化.
- 找出适应时间变化的患者特征.
主要方法:
- 在已故捐赠脏等候名单上对美国移植前患者进行了分离选择实验.
- 使用基于logit的回归分析以基于移植存活时间和等待时间之间的权衡来建模患者的偏好.
- 研究了患者共同变量的影响,包括年龄,胰岛素使用,接受者的功能,透析持续时间和家庭收入.
主要成果:
- 等待时间对患者的表型概率有非线性影响,随着时间的推移,接受低质量的脏的意愿增加.
- 较长时间依赖胰岛素,收入较低,健康功能较差的患者更倾向于接受不理想的脏.
- 更高的收入与等待更优质脏的可能性显著增加.
结论:
- 患者对器官可接受性的偏好是动态的,并且随着在移植等候名单上的时间而有显著变化.
- 健康状况和社会经济因素,如收入和胰岛素依赖,极大地影响了这些不断变化的偏好.
- 延长的等待期和健康状况通常与接受低质量的已故捐赠脏的增加有关.
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